Anaesthesia and Intensive Care最新文献_第3页

ChatGPT-4's capability in addressing multiple-choice questions within the primary examination of the Australian and New Zealand College of Anaesthetists. ChatGPT-4 解决澳大利亚和新西兰麻醉师学院初级考试中多项选择题的能力。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-23 DOI: 10.1177/0310057X241266625

Steven C Cai, Alpha Ms Tung

引用次数: 0

Urinary chloride excretion in critical illness and acute kidney injury: a paediatric hypothesis-generating cohort study post cardiopulmonary bypass surgery. 危重病和急性肾损伤时的尿氯排泄：心肺旁路手术后儿科假设队列研究。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-11 DOI: 10.1177/0310057x241265119

Adrian C Mattke,Kerry E Johnson,Krishanti Ariyawansa,Peter Trnka,Prem S Venugopal,David Coman,Andreas Schibler,Kristen Gibbons

{"title":"Urinary chloride excretion in critical illness and acute kidney injury: a paediatric hypothesis-generating cohort study post cardiopulmonary bypass surgery.","authors":"Adrian C Mattke,Kerry E Johnson,Krishanti Ariyawansa,Peter Trnka,Prem S Venugopal,David Coman,Andreas Schibler,Kristen Gibbons","doi":"10.1177/0310057x241265119","DOIUrl":"https://doi.org/10.1177/0310057x241265119","url":null,"abstract":"Renal chloride metabolism is currently poorly understood but may serve as both a diagnostic and a treatment approach for acute kidney injury. We investigated whether plasma chloride, ammonia and glutamine as well as urinary chloride, ammonium and glutamine concentrations may serve as markers for acute kidney injury in paediatric patients. We conducted a prospective observational trial in a tertiary care paediatric intensive care unit. Ninety-one patients after cardiopulmonary bypass surgery were enrolled. Plasma glutamine, creatinine, (serum) albumin, urinary electrolytes and glutamine were collected pre-cardiopulmonary bypass surgery, at paediatric intensive care unit admission, and at 6, 12, 24, 48 and 72 h after paediatric intensive care unit admission. The urinary strong ion difference was calculated. The median urinary chloride excretion decreased from 51 mmol/L pre-cardiopulmonary bypass to 25 mmol/L at paediatric intensive care unit admission, and increased from 24 h onwards. Patients with acute kidney injury had lower urinary chloride excretion than those without. The median urinary strong ion difference was 59 mmol/L pre-cardiopulmonary bypass, rose to 131 mmol/L at 24 h and fell to 20 mmol/L at 72 h. The plasma chloride rose from 105 mmol/L pre-cardiopulmonary bypass to a maximum of 109 mmol/L at 24 h. At 24 h the plasma chloride concentration was associated with the presence of acute kidney injury. There was no association between plasma or urinary amino acids and chloride excretion or kidney injury. In conclusion, renal chloride excretion decreased in all patients, although this decrease was more pronounced in patients with acute kidney injury. Our findings may reflect a response of the kidneys to critical illness, and acute kidney injury may make these changes more pronounced. Targeting chloride metabolism may offer treatment approaches to acute kidney injury.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":"8 1","pages":"310057X241265119"},"PeriodicalIF":1.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The nature of the response to airway management incident reports in high income countries: A scoping review. 高收入国家对气道管理事件报告的反应性质：范围审查。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 DOI: 10.1177/0310057X241227238

Yasmin Endlich, Ellen L Davies, Janet Kelly

{"title":"The nature of the response to airway management incident reports in high income countries: A scoping review.","authors":"Yasmin Endlich, Ellen L Davies, Janet Kelly","doi":"10.1177/0310057X241227238","DOIUrl":"10.1177/0310057X241227238","url":null,"abstract":"Adverse events associated with failed airway management may have catastrophic consequences, and despite many advances in knowledge, guidelines and equipment, airway incidents and patient harm continue to occur. Patient safety incident reporting systems have been established to facilitate a reduction in incidents. However, it has been found that corrective actions are inadequate and successful safety improvements scarce. The aim of this scoping review was to assess whether the same is true for airway incidents by exploring academic literature that describes system changes in airway management in high-income countries over the last 30 years, based on findings and recommendations from incident reports and closed claims studies. This review followed the most recent guidance from the Joanna Briggs Institute (JBI). PubMed, Ovid MEDLINE and Embase, the JBI database, SCOPUS, the Cochrane Library and websites for anaesthetic societies were searched for eligible articles. Included articles were analysed and data synthesised to address the review's aim. The initial search yielded 28,492 results, of which 111 articles proceeded to the analysis phase. These included 23 full-text articles, 78 conference abstracts and 10 national guidelines addressing a range of airway initiatives across anaesthesia, intensive care and emergency medicine. While findings and recommendations from airway incident analyses are commonly published, there is a gap in the literature regarding the resulting system changes to reduce the number and severity of adverse airway events. Airway safety management mainly focuses on Safety-I events and thereby does not consider Safety-II principles, potentially missing out on all the information available from situations where airway management went well.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"283-301"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Variations of nitrous oxide procurement per public hospital bed between Australian states and territories: A cross-sectional analysis. 澳大利亚各州和地区公立医院每张病床一氧化二氮采购量的变化：横截面分析。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 Epub Date: 2024-08-30 DOI: 10.1177/0310057X241262796

Elizabeth P Hu, Hayden Burch, Eugenie Kayak, Forbes McGain

{"title":"Variations of nitrous oxide procurement per public hospital bed between Australian states and territories: A cross-sectional analysis.","authors":"Elizabeth P Hu, Hayden Burch, Eugenie Kayak, Forbes McGain","doi":"10.1177/0310057X241262796","DOIUrl":"10.1177/0310057X241262796","url":null,"abstract":"We aimed to identify variations in nitrous oxide (N2O) procurement between Australian states and territories per public hospital bed by undertaking a cross-sectional analysis of N2O procurement data for all Australian public hospitals from 1 January 2017 to 30 June 2022. Data were obtained from state and territory departments of health. All Australian public hospitals across six states and two territories were included. We obtained N2O procurement data from Department of Health representatives from all states and territories, accounting for all 697 Australian public hospitals and four public dental hospitals. The main outcome measured in this study was N2O procurement per public hospital bed by state or territory. Across the 5 years (1 January 2017 to 30 June 2022) an average of 242,054 (standard deviation (SD) 16,222) kg of N2O, equivalent to 64,144 (4299) tonnes of carbon dioxide emissions (CO2e), were procured per annum. CO2e emissions from N2O purchase varied more than threefold per public hospital bed between different states/territories (0.47-1.48 CO2e tonnes per hospital bed). There were significant variations in N2O procurement between Australian states and territories when adjusted for public hospital bed numbers. Further analysis of this variation to determine cause and to guide mitigation interventions is therefore warranted.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"321-327"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Just-in-time training for nasotracheal intubation: A report of a pilot study. 鼻气管插管的即时培训：试点研究报告。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 Epub Date: 2024-09-03 DOI: 10.1177/0310057X241261389

Nellie Dick, Jacqueline H Byrne, Debbie L Massey, Kersi J Taraporewalla

引用次数: 0

Patient rating of postoperative outcome measures. 患者对术后结果的评分。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 Epub Date: 2024-09-03 DOI: 10.1177/0310057X241261391

Chloe J Ashhurst, Natalie A Smith

引用次数: 0

Hirudin and the evolution of leeches in medicine. 水蛭素和水蛭在医学中的演变。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 DOI: 10.1177/0310057X241265610

Christine M Ball, Peter J Featherstone

引用次数: 0

A single-centre retrospective study of the utility of routine chest X-ray post intrathoracic drain removal in cardiothoracic surgical patients. 一项关于心胸外科患者胸腔内引流管移除后常规胸部 X 光检查效用的单中心回顾性研究。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 Epub Date: 2024-08-30 DOI: 10.1177/0310057X241257529

Reece D Rowbottom, Hemang P Doshi, David Bowen

{"title":"A single-centre retrospective study of the utility of routine chest X-ray post intrathoracic drain removal in cardiothoracic surgical patients.","authors":"Reece D Rowbottom, Hemang P Doshi, David Bowen","doi":"10.1177/0310057X241257529","DOIUrl":"10.1177/0310057X241257529","url":null,"abstract":"Routine chest X-ray (CXR) post intrathoracic drain removal in cardiac surgical patients is common practice to identify the presence of a pneumothorax following drain removal. Such pneumothoraces occur infrequently and rarely require intervention. We investigated the utility of routine CXR post drain removal and hypothesised that the practice is unnecessary and a possible area for significant cost saving. We conducted a single-centre, retrospective study of 390 patients who underwent cardiac surgery over a one-year period. Routine CXR post drain removal was reviewed for the presence of a pneumothorax. Rates of intervention post routine CXR were analysed to assess for clinical benefit obtained from this practice. Potential cost savings were calculated by the cost of a mobile CXR and by considering the radiographer's time. There were 15 pneumothoraces detected on routine CXR post drain removal. All pneumothoraces detected on routine post drain removal CXR were defined as small. No patients had a clinically significant pneumothorax requiring re-insertion of a chest drain. The potential cost saved by omitting routine CXR post drain removal was estimated to be approximately A$7750 per year. This study did not detect any clinically significant pneumothoraces requiring intervention. It also suggests that routine CXR post drain removal does not provide any clinical benefit and indicates that current practice should be reviewed.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"314-320"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Oesophageal intubations in anaesthetic practice across Australia and New Zealand: A webAIRS analysis of 109 incidents. 澳大利亚和新西兰麻醉实践中的食管插管：对 109 起事件的网络 AIRS 分析。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 Epub Date: 2024-08-31 DOI: 10.1177/0310057X241244809

Yasmin Endlich, Thomas P Fox, Martin D Culwick, Christopher J Acott

{"title":"Oesophageal intubations in anaesthetic practice across Australia and New Zealand: A webAIRS analysis of 109 incidents.","authors":"Yasmin Endlich, Thomas P Fox, Martin D Culwick, Christopher J Acott","doi":"10.1177/0310057X241244809","DOIUrl":"10.1177/0310057X241244809","url":null,"abstract":"Oesophageal intubations are more common than may be realised and can potentially cause significant patient harm even if promptly identified and corrected. Reports of morbidity due to unrecognised oesophageal intubation continue to present in coroner and media reports. Therefore, it would be helpful to identify mechanisms to prevent these events and implement strategies to avoid and identify incorrect endotracheal tube placement. This analysis of oesophageal intubations reported to webAIRS aims to provide an in-depth analysis of all events in which oesophageal intubation occurred. WebAIRS is a web-based, bi-national incident reporting system collecting voluntarily reported anaesthetic events across Australia and New Zealand, with more than 10,500 incidents registered. A structured search through the webAIRS database identified 109 reports of oesophageal intubation reported between July 2009 and September 2022. A common cause of oesophageal intubation was the misidentification of the larynx due to a poor laryngeal view. Desaturation directly attributed to the misplaced endotracheal tube occurred in 43% of all reports. The authors precisely defined early recognised oesophageal intubation and delayed or unrecognised oesophageal intubation. Most reports (74%) described early recognition of the misplaced intubation, of which 27% led to directly contributed to hypoxia. Cardiovascular collapse as a direct consequence of the late recognition of oesophageal intubation was described in five (18%) of these events. There was inconsistency in end-tidal carbon dioxide monitoring and interpretation of the resulting waveform. Findings show that oesophageal intubation continues to be an issue in anaesthesia. Incidents described confusion in diagnosis, human factors issues and cognitive bias. Clear diagnostic guidance and treatment strategies are required to be developed, tested and implemented.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"302-313"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Taipan envenoming … south of the border. 氹仔......南部边境。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-09-01 Epub Date: 2024-09-05 DOI: 10.1177/0310057X241247852

Rachel Heap, Aaron Kennedy, William Davies, Theo Tasoulis, Geoffrey K Isbister

引用次数: 0